PYRIMETHAMINE The preventative or suppressive dose of Blood tests will be done regularly to pyrimethamine is usually 25 to 75 mg daily. check for any changes in these values. To prevent these adverse effects you Other NAMES: Daraprim  Your dosage is: will be asked to take folinic acid (Leucovorin ). Inform your doctor if WHY is this drug prescribed? 25 mg tablet: you notice any symptoms such as fever, chills, shortness of breath, racing Pyrimethamine is an antiparasitic agent Day 1: heartbeat, fatigue, bleeding or bruising. that is used to treat and prevent a ____tablets (____mg) once daily variety of infections, including Nausea, vomiting, abdominal pain, Toxoplasmosis, an infection of the afterwards: and diarrhea can also occur. If these brain. It can also be used to prevent effects do happen, take the drug with and treat certain types of malaria. ____tablets (____mg) once daily food. If they remain bothersome, call your doctor or pharmacy. HOW should this drug be taken? Pyrimethamine can be taken with or without food. Insomnia, headache, dryness of Pyrimethamine is available as 25 mg mouth or throat, and mouth ulcers white tablets. What should you do if you FORGET a are adverse events that are rarely dose? seen. This drug is used together with other drugs such as sulfadiazine If you miss a dose of pyrimethamine, take it It is important that you keep your  (Microsulfon ) or clindamycin as soon as possible. However, if it is time doctor appointments and come for  (Dalacin C) in the treatment and for your next dose, do not double the dose, your laboratory tests so that your prevention of recurrences of just carry on with your regular schedule. progress can be followed. toxoplasmosis . Pyrimethamine is also usually given together with folinic What ADVERSE EFFECTS can this drug What other PRECAUTIONS should  acid (Leucovorin ) to counteract the cause? What should you do about them? you follow while using this drug? effects of pyrimethamine on the blood. Allergic reactions with skin rash and Certain drugs can increase or decrease Pyrimethamine can sometimes be itching can occur. If this happens, call your the effect of pyrimethamine. Also, given for the prevention of doctor. pyrimethamine might influence the Pneumocystis carinii pneumonia, in effect of other drugs you are taking. combination with dapsone Pyrimethamine can cause a decrease in Inform your doctor and pharmacist of  (Avlosulfon ). certain types of blood counts. Anemia (a all prescribed and non-prescribed reduced number of red blood cells that can drugs you are taking. As well, you The treatment dose of pyrimethamine make you feel tired or short of breath), should inform them of natural products in adults is 200 mg on the first day, leucopenia (a decrease in the number of you are taking. If you wish to start a then followed by 50 to100 mg daily for white blood cells so that you have a higher new drug or natural product, please 6 weeks. risk of bacterial infection), or consult with your pharmacist before thrombocytopenia (a decrease in the doing so. number of platelets that can increase your risk of bleeding or bruising) may occur. In particular, you could be at increased (“EXP”) shown on the outside of the risk of adverse events if you are taking package. the following drugs: Do not store in your bathroom or kitchen, as Anti-cancer drugs: chemotherapy heat and moisture may cause the drug to Lorazepam (Ativan ) be less active. Quinine PYRIMETHAMINE Trimethoprim (Proloprim ) If you have any questions or concerns Trimethoprim + Sulfamethoxazole about this drug or if you are (Bactrim , Septra ) experiencing adverse effects, please

Warfarin (Coumadin ) discuss them with your pharmacist, Zidovudine (Retrovir ) doctor or nurse.

Also, antacids (Maalox , Tums , etc) Write questions or concerns down to and agents containing kaolin ensure they are addressed. MEDICATION (Donnagel ) can decrease the absorption of pyrimethamine. Avoid The following pharmacist is available to answer questions: using these agents or take them at least 2 hours after the pyrimethamine FACT SHEET dose. Pharmacist: ______Telephone: ______Inform your doctor if you have a history of epilepsy (convulsions), liver or kidney disease.

Before starting this drug, tell your doctor if you are pregnant or breastfeeding. Use of pyrimethamine during pregnancy needs to be discussed with your doctor. Breastfeeding is NOT recommended while you are taking pyrimethamine.

How should this drug be STORED?

 Pyrimethamine should be stored in a Reference: Product Monograph Daraprim ° (pyrimethamine). St-Laurent, Qc, Canada: cool (15-30 C) dry place, protected GlaxoSmithKline, 2002. Prepared by the Ontario HIV from light and well out of the reach of Pharmacy Professional Specialty Group, 2003. Reviewed children. Ensure that the drug has not 2009. expired by checking the expiry date Additional medication fact sheets and updates may be found at: www.hivclinic.ca